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On-line version ISSN 2078-5135Print version ISSN 0256-9574

SAMJ, S. Afr. med. j. vol.101 n.7 Cape Town Jul. 2011

CORRESPONDENCE

Decriminalisation of drugs

To the Editor: The progressive opinion expressed in your February editorial1 in the traditionally conservative SAMJ is to be lauded. The decriminalisation of drugs debate is usually such a political hot potato that no one wants to touch it. However, the war on drug users remains one of society's long-standing civil wars, now being played out on an international stage in Afghanistan, where the quibble is largely over who controls the world's opium supply, 92% of which comes from the poppy fields of that country.2

My work in the field of substance dependence treatment for the past 20 years has convinced me that declaring drugs illegal does not in the slightest act as a deterrent for the 10% of drug-dependent users who cause 90% of the drug-related problems. Many problems arising from drug use result from the fact that the substances are illegal, and not from the drugs themselves. Even the very act of being a non-problematic drug user is in itself a criminal event.

The big fear most people harbour is that decriminalising, regulating or even legalising drugs will increase the prevalence of substance use behaviour. While this might be true to an extent, the perception that liberalisation will overwhelm and result in a nation of drug users is unfounded.

The legalisation of commercial gambling in South Africa in 1996 provides useful empirical evidence. Similarly the fear then was that legalisation of this previously prohibited industry would create a nation of problem gamblers. Yet prevalence studies3 show that the incidence of problem gambling in this country has not increased since its legalisation, despite the dramatic increase in the commercial size of the industry.

The likely increase in the prevalence of substance use that will result from decriminalisation of the activity must be carefully weighed against an inevitable decrease in the massive worldwide morbidity and mortality that currently arises from an illegal industry.

Prohibition of drugs simply creates an underground economy that cannot be taxed, controlled or regulated. It causes corruption and fills the prisons with people found guilty of a victimless crime. It creates extremely lucrative monopolies for those prepared to take the risk, but does very little to deter those intent on drug use, which was the purpose of the prohibition.

Professor Hamid Ghodse, professor of psychiatry and drug policy and several times head of the International Narcotics Control Board and a long-standing drug war warrior, recently stated: 'Legalization arguments don't withstand critical evaluation and run contrary to general expectations. Proponents have yet to produce viable proposals. Liberalisation would irrevocably impact public health, social well-being and international stability.'4 Our challenge is to manage the problems arising from liberalisation of drug laws rather than bury our heads deeper in the sand, believing that we can legislate the problem away.